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Ind. Health Department Revises HPV Vaccine Notification Letter

The Indiana State Department of Health has altered language in a reminder notice to parents in the state whose children have not yet received the human papillomavirus vaccine in response to concerns about the original notice, AP/WISH TV 8 reports.


In September, ISDH sent a reminder letter to 305,000 Indiana residents whose children were not on record as having received the HPV vaccine. According to AP/WISH TV 8, the letter stated that HPV posed a serious public health risk and called on parents to ensure their children received the vaccine (AP/WISH TV 8, 11/6). The letter did not specify that the HPV vaccine was voluntary.

According to the Fort Wayne Journal-Gazette, the conservative American Family Association of Indiana criticized the letter in an email to members, calling the vaccination initiative a state intrusion into private matters. Indiana Gov. Mike Pence (R) agreed to review the situation.

Details of New Letter

ISDH spokesperson Jennifer O'Malley said the follow-up letter aims "to clarify the language" used in the original letter. She said the new letter will be mailed to 175,000 parents and makes clear that while the HPV vaccine is recommended by CDC, Indiana does not require it.

The new letter also acknowledges that ISDH frequently reviews immunization records reported to the Children and Hoosier Immunization Registry Program. The letter provides a link to have a child's information permanently removed from the immunization database.

It also notes that HPV is so common that almost all sexually active people will be infected at some point in their lives, adding that while the infections typically resolve themselves, the virus can cause cervical cancer in women. The letter retains comments made in the first letter about medical associations' support for the vaccine.

Medical Experts Voice Concerns

Last week, more than 30 medical professionals and professors with the Center for HPV Research at the Indiana University School of Medicine sent a letter to Pence urging him not to soften the language of the letter.

"A long-standing and evidence-based practice to encourage vaccination is the use of reminder recall letters addressed to parents and guardians of children who have not initiated or completed the vaccination series," the researchers wrote, adding, "Hoosier parents have been receiving these letters since 2012, and there have been at least three letter cycles sent to parents specifically focused on HPV vaccination."

The researchers said the low HPV vaccination rates in Indiana are "of great concern to us as cancer researchers, because the vaccine is both safe and effective." According to federal statistics, about 23% of Indiana girls age 13 to 16 have received all three injections of the vaccine.

In addition, the researchers noted that concerns about the database are "unfortunate, because the registry is a central component of a comprehensive public health strategy against all vaccine preventable diseases," adding, "The concerns are without merit, and merely attempt to unravel important public health advances at the expense of Hoosier health" (Kelly, Fort Wayne Journal Gazette, 11/6).